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Adverse Pregnancy Outcomes in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis
Jennifer H Yo1,2,3, Neville Fields4,3, Wentao Li5,6
1Department of Nephrology, Monash Health, Melbourne, Victoria, Australia.
JAMA Network Open
|August 29, 2024
Summary
Pregnancies in solid organ transplant recipients have a significantly higher risk of preeclampsia, preterm birth, and low birth weight. However, the risk of allograft rejection or loss during pregnancy remains low.
Area of Science:
- Reproductive Medicine
- Transplant Surgery
- Maternal-Fetal Medicine
Background:
- Solid organ transplant recipients face elevated risks of adverse pregnancy outcomes.
- Contemporary data on these risks and allograft outcomes during pregnancy are limited.
Purpose of the Study:
- To assess the association between solid organ transplantation and adverse pregnancy outcomes.
- To quantify the incidence of allograft rejection and loss in pregnant transplant recipients.
Main Methods:
- Systematic review and meta-analysis of cohort and case-control studies (2000-2024).
- Searched PubMed/MEDLINE, EMBASE, and Scopus databases.
- Included 22 studies involving over 93 million pregnancies.
Main Results:
- Organ transplant recipients had significantly increased risks: preeclampsia (aOR 5.83), preterm birth (aOR 6.65), and low birth weight (aOR 6.51).
- Incidence of acute allograft rejection was 2.39%.
- Incidence of allograft loss during pregnancy was 1.55%.
Conclusions:
- Pregnancy in solid organ transplant recipients is associated with a 4-6 fold increased risk of major adverse outcomes.
- The overall risk of graft rejection or loss during pregnancy is low.
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